颅内视神经-视交叉胶质瘤的诊断及手术治疗

目的讨论颅内视神经-视交叉胶质瘤的临床特点及手术治疗。方法对我科近6年来手术治疗和病理证实的11例视神经-视交叉胶质瘤患者的临床资料进行回顾性分析。结果视力下降、视野缺损及视神经萎缩是该类肿瘤的主要表现,82%为低级别星形细胞瘤,M RI可良好显示肿瘤生长特点及与周围结构的关系。手术全切除4例、次全切5例、部分切除2例,仅1例术后视力恶化,无死亡病例,总体恢复良好。结论颅内视神经-视交叉胶质瘤有其特点,显微神经外科手术治疗效果好、应该作为该类肿瘤的首选治疗方法。

Diagnosis and Surgical Treatment of Intracranial Optic Nerve-Chiasm Gliomas

Objective To explore the clinical features and surgical treatment of intracranial optic nerve-chiasm gliomas. Method Theclinical data of 11 patients with intracranial optic nerve-chiasm gliomas resected by microsurgery and verified by postoperative pathology, were analysed retrospectively. Results Visual deterioration, visual field defect and optic nerve atrophy were three major symptoms in the patients with intracranial optic nerve-chiasm gliomas. Eighty-two per cent of the intracranial optic nerve-chiasm gliomas were low-grade astrocytomas. MRI could show well the tumor growth and adjacent anatomical structures. Of 11 patients under-going microsurgery, 4 reseived total removal of the tumor, 5 subtotal and 2 partial. The postoperative visual deterioration was observed only in one cases and no patients died from the operation. Most patients got satisfactory recovery. Conclusions The intracranial optic nerve-chiasm glioma has its specific clinical features and the microsurgery may serve as the first choice of its treatment.